As I am on service, I realized that one thing that can be easily lost in the race to take care of patients with limited duty hours – the social history. The social history is part of the admission “history and physical” that once included a myriad of information about the patient’s job, life, and habits has now “fallen into despair” becoming little more than “negative for TED”, or in other words “no tobacco, alcohol (ethanol) or drugs.” But, there is so much more to it than that. How do they afford to pay for their housing, food, and medications? Do they have insurance? Where do they live? Who takes care of them or do they take care of someone else? Do they have friends or family living nearby? What do they like to do for fun? Given that most of the ‘discharge planning’ focuses on these elements of the social history, it seems silly that we don’t include more than just no TED. So, when I was asked by a very astute medical student if I preferred to hear more in the social history, I said yes. The information that is usually discussed as the patient gets better and we wonder where they will go was now presented on admission, discussed as a problem just like any other medical problem. In just a few short days, we discerned that a...

Exciting news! Our sister site, The Doctor’s Channel has partnered with the Centers for Disease Control and Prevention (CDC) in order to promote their monthly Vital Signs report. The CDC’s Vital Signs is released on the first Tuesday of the month and is comprised of an early release of the CDC’s Morbidity and Mortality weekly report (MMWR) as well as a fact sheet pertinent to the topic and several social media announcements. The reports call attention to important public health topics, urging the healthcare community to take action. The January 2014 Vital Signs report addresses the issue of excessive drinking and highlights a preventive service plan comprised of alcohol screening and brief counseling. Why talk about excessive drinking? Drinking too much or excessive drinking contributes to many negative health outcomes, including medical conditions such as hypertension, cancer, and liver diseases. Additionally, the misuse of alcohol can have social consequences including, but not limited to, car accidents, partner abuse, or birth defects in children on the fetal alcohol syndrome spectrum. Excessive drinking also contributes to excessive government spending, where approximately $22.5 billion is spent annually on alcohol abuse healthcare and a total of $175.9 billion is spent on alcohol related problems. Alcohol screening and brief counseling is an effective but underused health service and should become part of the overall screenings that health professionals provide. Who is the CDC talking to? It is the CDC’s goal to inform the public of the dangers and consequences of excessive drinking. However,...

All alone! Whether you like it or not, alone is something you’ll be quite a lot! – Dr. Seuss What’ll we do with ourselves this afternoon? And the day after that, and the next thirty years? – Ke$ha It is a logic that many drug abusers would understand. It goes like this: I feel bad, and drugs make me feel good, although they are also why I feel bad. But since they make me feel good now, and bad later, I will worry about later when the time comes. – Roger Ebert I am not proud of the fact that major ingredients of my emotional history are available for purchase today at CVS. – Nicholson Baker I think it goes without saying that pretty much everything I’ve taught you should be prefaced with a ‘No homo.’ – Jesus Christ Now the standard cure for one who is sunk is to consider those in actual destitution or physical suffering – this is an all-weather beatitude for gloom in general and fairly salutary day-time advice for everyone. But at three o’clock in the morning, a forgotten package has the same tragic importance as a death sentence, and the cure doesn’t work – and in a real dark night of the soul it is always three o’clock in the morning, day after day. – Jackie Chan I discovered that if one looks a little closer at this...

1. Follow any thematic guidelines provided by the people throwing the party — nobody likes someone who shows up empty-handed or out-of-costume. If it’s BYOB, bring your own beer. If it’s a toga party, wear a toga. If it’s a search party, bring a flash light and tempered expectations. 2. Everyone knows that if you go to prison, you need to show everyone you’re tough and can take care of yourself right off the bat. Usually this is done by beating up the first guy who messes with you. Well, being cool at a party works the same way — you need to show how cool you are as soon as you walk in the door. One method is to show up already wasted, like “Who needs a party? I’m cool drug-addicted guy!” Another is to walk up to the coolest person already at the party and just do a really elaborate magic trick. WARNING: Do not combine these two strategies. Drunken magic, while cool, can be very dangerous. 3. Don’t start conversations with, “A/S/L?” 4. Don’t bring your mom. Like, don’t even let her wait in the car. But if you do, take my advice and remember to roll the windows down. 5. You know how you usually feel like sobbing during social gatherings because you feel so unmistakably alone? How you are inescapably struck by the futility of meaningful...

A few years ago, one of my classmates passed away, and suddenly, my news feed was flooded with mourning. People spoke of what a great person they were and their lovable personality. They reflected on their times playing sports together and the great memories they made at college parties. They spoke of how – at a young age – this person had a bright future that they unfortunately do not get to see. What people didn’t speak of is that this person, though having recently gone to rehab, died of a heroin overdose. Upon hearing this, I was flooded with questions. What if someone had done more to help them? What if they had made a more conscious decision to fight their addiction? Why did their abuse of drugs start? Why did their rehab not work? Why did their life have to end at such a young age? What if there was something I could have done when we were classmates to prevent their life from ending up this way? Alas, these questions have no easy answers and in retrospect have no use for my classmate. Recently, many of them came racing back to my mind upon hearing of the death of Oscar-winning actor Philip Seymour Hoffman. After more than two decades sobriety with a relapse and rehab last spring, he was found dead with a hypodermic needle in...